Development, feasibility, efficacy, and cost-effectiveness of an online ACT intervention for Disorders of Gut-Brain Interaction (iACTforDGBI)

Research problem and specific questions: Disorders of Gut-Brain Interaction (DGBI) are a group of highly prevalent gastrointestinal disorders with large healthcare costs and high comorbidity with psychological distress. Even though psychological distress is an important factor in DGBI, most patients never receive psychological treatment.

Acceptance and Commitment Therapy (ACT) is a theory-based intervention with demonstrated efficacy in numerous psychological and physical conditions, but lacks evidence in DGBI.

This project aims to develop and test a self-guided online ACT intervention (iACTforDGBI) designed for people with DGBI and comorbid psychological distress.Data and method: This project includes 4 studies with different aims: Study 1 comprises the development of the iACTforDGBI intervention from previously tested interventions and focus group interviews.

Study 2 tests the intervention’s acceptability and feasibility through a pilot study with 30 people with DGBI and 15 healthcare professionals, and will inform the refinement of the intervention.

Study 3 evaluates its efficacy through a Randomized Controlled Trial with 276 people with DGBI and comorbid psychological distress. The intervention will be compared to an active control condition (online education on DGBI).

Evaluation of efficacy will include changes in anxiety and depressive symptoms, quality of life, work absenteeism and presentism, gastrointestinal symptoms, and psychological flexibility from baseline to post-treatment and 6- and 12-months follow-up.

Study 4 will evaluate the cost-effectiveness (evaluation of economic costs) of the intervention, based on the data collected in Study 3.Societal relevance and utilisation: This project aims at alleviating the burden associated with DGBI and the lack of access to mental healthcare faced by people with these disorders.

Results will create opportunities for the implementation of the iACTforDGBI intervention in the usual healthcare of people with DGBI in Sweden, promoting their well-being and empowerment, and potentially decreasing costs.Plan for project realisation: This project will be conducted by a multidisciplinary team comprising psychologists (ACT researchers), a physician, a dietitian, a nurse, a health economist, and a qualitative researcher, all with previous experience in DGBI.

Funds required include the services of a web development company, ACT therapists, costs for time and effort from the research team, and dissemination.